Healthcare Provider Details

I. General information

NPI: 1225637861
Provider Name (Legal Business Name): MVMT PERFORMANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 EAYRESTOWN RD
SOUTHAMPTON NJ
08088-9122
US

IV. Provider business mailing address

163 TABERNACLE RD
MEDFORD LAKES NJ
08055-2024
US

V. Phone/Fax

Practice location:
  • Phone: 856-266-4910
  • Fax:
Mailing address:
  • Phone: 856-266-4910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN TODD FILER
Title or Position: OWNER
Credential: DPT, ATC
Phone: 609-845-3585